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Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study

Abstract

Background

The Berlin Questionnaire (BQ) is a useful tool to identify the high-risk group for obstructive sleep apnea (OSA) in the primary care sites or hospital, but the usefulness of the BQ to identify the high-risk group for OSA in the general population has not been evaluated. The purpose of our study was to develop the Korean version of the BQ (KBQ) and evaluate the usefulness of the BQ in identifying patients with OSA in the general population.

Methods

A total of 1,305 subjects were included in a population-based door-to-door cross-sectional study. For validation of the KBQ, an overnight polysomnography (PSG) was performed on 101 subjects who were randomly selected considering their age, sex, and risk group classification at a controlled sleep laboratory.

Results

The KBQ showed a relatively good to excellent internal consistency (Cronbach’s α correlation 0.64–0.78) and test–retest reliability (intraclass correlation 0.92). The apnea–hypopnea index (AHI) was significantly correlated with the scores in each category and the total scores of the KBQ. In addition, high risk grouping based on the KBQ predicted an AHI ≥ 5 with a sensitivity of 0.69 and a specificity of 0.83. According to the risk categorization based on the KBQ, 26.1 % subjects were in the high-risk group for OSA which was similar to the prevalence of OSA in a previous large epidemiological study using PSG in Korea.

Conclusion

This is the first study to confirm the usefulness of the BQ as a screening tool for OSA by prioritizing subjects at high risk for OSA in the general population.

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Acknowledgments

This research was supported by a grant of Korea Centers for Disease Control and Prevention, Republic of Korea (2009-E33029-00) and by Kyungpook National University Research Fund, 2012.

Conflict of interest

This was not an industry-supported study. The authors have indicated no financial conflicts of interest. There is no off-label or investigational use in this study.

Author information

Correspondence to Ho-Won Lee.

Additional information

Kyunghun Kang and Ki-Soo Park contributed equally to this work.

Appendix. The Korean version of Berlin Questionnaire

Appendix. The Korean version of Berlin Questionnaire

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Kang, K., Park, K., Kim, J. et al. Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea: a population-based door-to-door study. Sleep Breath 17, 803–810 (2013). https://doi.org/10.1007/s11325-012-0767-2

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Keywords

  • Berlin Questionnaire
  • Obstructive sleep apnea
  • Sleep-disordered breathing
  • Polysomnography
  • General population
  • Validity